气管插管冲洗治疗胎粪吸入综合征44例

Cure meconiun aspiration syndrome by undergo intrapartum suction and study its clinic effect

目的观察气管插管冲洗治疗胎粪吸入综合征40例的临床疗效。方法回顾分析胎粪吸入综合征(MAS)79例。其中气管插管冲洗40例为治疗组;无气道插管冲洗39例为对照组。观察两组的疗效。治疗组除在头及全身娩出后各进行一次口、鼻、咽部清吸外,要在15-20s内完成清吸、刺激、供氧等措施。后治疗组予以气管插管用0.5ml生理盐水反复冲洗至液体变清为止。结果①血气分析中:两组在0-3h的各项数值无显著性差异;但在4-24h的数值(除pH、PCO2外)PO2、Pao2a/A之间均有显著性差异(P<0.05)。②治疗组较对照组在治愈率、上机人数率、合并症率、死亡率的比较有显著性差异(P<0.05)。③治疗组较对照组可缩短治愈患儿住院天数,两组之间有显著性差异(P<0.05)。结论对有粘稠胎粪、合并窒息、产前有导致窒息的高危因素的胎儿于吸净气管内分泌物后立即气管插管予以气道冲洗,可以减少胎粪吸入综合征的发生率。

Objective ： We cure meconiun aspiration syndrome by endotracheal suction and study its clinic effect. Methods： seventy - three meconiun aspiration syndrome infants were randomly divided from two groups ; the treated group （n = 40） and the control group （n =39）. Two groups received endotracheal suction at birth and finish suction, giggle, breath option in 15 -20 s. After that whether they are asphyxiated or not, the treated group was undergo intrapartum suction by 0. 5 - 1ml 0. 9% natrid chorodiat immediately. Results. ①blood gas： It is not different between the two groups （ P 〈 0. 05） at 0 - 4 hours. There were significant differences in PO2, Pao2a/A within 4 -24 hours between the two groups （ P 〈0. 05）. ②at the exams, There were significant differences in cure＇s rate, death＇s rate, using by breath machine＇s rate and combine syndrome＇s rate between the two groups （ P 〈0. 05）. ③the cured newborn＇s hospital days in the treated group significant differences from that of the control group （ P 〈 0. 05）. Conclusion： It＇s nessury for those babies with thick meconiun, asphyxia, high asphyxia＇ rate to receive endotracheal suction at birth and undergo intrapartum suction by 0. 5 - 1ml 0. 9%natrid chorodiat immediately. It could reduce meconium aspiration syndrome＇s rate.